Abstract

The prognosis of unstable angina pectoris (UAP) differs from non-ST-segment elevation myocardial infarction, and percutaneous coronary intervention (PCI) is considered to improve outcomes of UAP. This study aimed to assess the prognostic value of uric acid to albumin ratio (UAR) for long-term mortality in UAP patients after PCI. Our study retrospectively enrolled 2298 patients hospitalized because of UAP in a tertiary hospital. Divided by medium UAR, the patients were classified into two groups. Baseline demographics, clinical features and laboratory characteristics were obtained from medical records. Post-discharge follow-up was performed either in outdoor clinic or through phone call. The primary endpoint in this study was cardiac death, while all-cause death and rehospitalization were designated as the secondary endpoints. The median follow-up time was 672 days. Among all patients, 58 (2.5%) died, 28 of which died of cardiac deaths (1.2%), and 467 were re-hospitalized (20.3%). Cardiac mortality and all-cause mortality were found to be significantly higher in the high UAR group than in the low UAR group (p = 0.007, p < 0.001), and Kaplan–Meier analysis showed patients with higher UAR may suffer from worse outcomes (p = 0.020). UAR, PCI history, and age were identified as independent predictors of cardiac mortality by multivariate Cox regression. A UAR value of >8.35 was demonstrated as an ideal cut-off point to predict post-PCI cardiac mortality (p <0.001). Overall, it is indicated that baseline UAR was independently correlated with long-term cardiac mortality in patients with UAP treated by PCI.

摘要

不稳定型心绞痛（UAP）的预后不同于非ST段抬高型心肌梗死，经皮冠状动脉介入治疗（PCI）被认为可以改善UAP的预后。本研究旨在评估尿酸与白蛋白比值 (UAR) 对 UAP 患者 PCI 后长期死亡率的预后价值。我们的研究在一家三级医院回顾性招募了 2298 名因 UAP 住院的患者。按中UAR划分，将患者分为两组。从医疗记录中获得基线人口统计学、临床特征和实验室特征。在户外诊所或通过电话进行出院后随访。本研究的主要终点是心源性死亡，而全因死亡和再住院被指定为次要终点。中位随访时间为 672 天。在所有患者中，58人（2.5%）死亡，其中28人死于心源性死亡（1.2%），467人再次住院（20.3%）。发现高 UAR 组的心脏死亡率和全因死亡率显着高于低 UAR 组。p  = 0.007, p  < 0.001），Kaplan-Meier 分析显示 UAR 较高的患者可能会遭受更差的结果（p  = 0.020）。UAR、PCI 病史和年龄被多变量 Cox 回归确定为心脏死亡率的独立预测因子。UAR 值 >8.35 被证明是预测 PCI 后心脏死亡率的理想截止点 ( p <0.001)。总体而言，表明基线 UAR 与接受 PCI 治疗的 UAP 患者的长期心脏死亡率独立相关。